Renal conditions Flashcards
1.
Haemolytic Uraemic syndrome( STEC-HUS)
- Caused by E.coli
- Acute renal failure
- Haemolytic anaemia
- Thromocytopenia
- Haemorrhagic colitis
How do you get HUS
- Infection
-E.coli
-Streptococcus pneumoniae
-HIV - Atypical haemolytic uraemic syndrome
Complications of HUS
Renal replacement therapy in 2/3 cases
Neurology
Haemorrhagic colitis
Bowel ischaemia/necrosis/perforation
Pancreatitis
Nephrotic syndrome
Proterinuria
Hypoalbinaemia
Oedema
SSNS (Steroid sensitive nephrotic syndrome)
Biopsy finding
Glomeruli normal under light microscopy
Podocyte foot process effacement under EM
Steroid resistant nephrotic syndrome
Most common biopsy finding is FSGS (focal segmental glomerulosclerosis)
50-60% will progress to end stage renal disease
genetic causes
Oedema formation
- Kidneys leak protein (>1g/m2/day – 3-4+ on dipstick) - albumin
- Lowers the plasma oncotic pressure
- Fluid then leaks into the interstitium by osmosis, depleting the intravascular volume
- Activates renin-angiotensin pathway and ADH secretion
- Retention of sodium and water
- Further increases oedema
Treat this with 4.5% albumin IV or 20%
Aim of care for AKI patients
Medication
Monitor child
Family support
Urological conditions
Dysfunctional voiding
Posterior Urethral Valves
Vesicoureteral reflux
Hypospadius
What is Dysfunctional voiding
A problem with bladder emptying caused by poor communication between the bladder muscles and the urethral sphincter. The bladder and pelvic floor muscles do not relax at the same time, making it difficult to pass urine.
What might people with dysfunctional voiding present with
Presentation: urinary tract infections, day/night incontinence
Hypospadius
Hypospadias occurs when the opening of the urethra isn’t located at the tip of the penis.
The urethra normally forms early in foetal development at around 8–14 weeks gestation. However, in babies with hypospadias, the opening of the urethra forms anywhere from just below the end of the penis to the scrotum.
This can make urinating more complex and also cause the penis to develop a hooded appearance because only the top half of the penis is covered by the foreskin.
What causes hypospadias
Foetal development
Family history of hypospadias
specific genetics that disrupt the hormones responsible for the formation of a penis
pregnancy in those considered obese
pregnancy in those over the age of 35
taking certain hormones just before or during pregnancy
Posterior Urethral Valves
A congenital obstructive urological defect where there is a blockage in the posterior urethra – affecting only males
Presentation of Posterior Urethral Valves
Antenatal ultrasound scans show swelling of the bladder, ureters or kidneys
Late presentation with swollen bladder, dribbling urine
